Getting to the heart of why kids cut

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Cutting, where people use everything from razor blades to pins and needles to injure their skin, can occur in everyone from the school intellectual to the three-sport athlete to the teen addicted to drugs and alcohol, says Lisa Grant, a psychologist with Anne Arundel County Public Schools,

There is Anne, an extremely intelligent and highly anxious eighth grader, who is driven to succeed in everything she does.

And Peter, the competitive star of his high school soccer team, who is outgoing and friendly to everyone he meets.

Then Sarah, a quiet and shy college freshman who has experienced physical abuse since age 12.

On the outside, they appear to have nothing in common, but pull back their sleeves and you’ll see their shared secret: arms covered in self-inflicted cuts and scratches.

Anne, Peter and Sarah are cutters, teens who intentionally harm themselves to cope with and gain control over emotions. Though their names have been changed, they represent about 15 percent of adolescents nationwide who self harm, local therapists say.

“There’s not necessarily a face for cutting,” says Grant, who has run across similar versions of these students throughout the past decade.

Both boys and girls cut, with most starting during their tween or teen years, experts say.

If you have recently found out that your tween or teen cuts, know that you are not alone. While statistics are limited, a study published in the March 2012 Child and Adolescent Psychiatry and Mental Health journal estimated that 12 to 23 percent of teens have engaged in non-suicidal self-injury like cutting, skin burning and skin carving.

Experts say the issue of cutting is not new, but in recent years, awareness and discussion of the behavior has grown.

“These kids are crying out for help to manage their feelings,” Grant says.

Why and where they cut

Reasons for cutting vary, experts say.

Some of the more common triggers include a history of trauma like abuse, an unstable home life, bullying, drug and alcohol use, and academic and social pressure.

“A lot of times, kids who engage in self-harm, they’re not equipped with good coping skills,” says Alison Bomba, an Ellicott City psychologist who works with children, teens and young adults. “They have a hard time expressing themselves, and they haven’t learned how to process overwhelming emotions.”

By cutting themselves, teens who are feeling numb say they feel more alive, Bomba says. The impulsive act can also be a form of self-punishment or a physical way to mask emotional pain, she says.

For example, teens who have experienced trauma say the act of cutting reenacts the trauma while giving them some control over the pain, Grant says. Once they cut, endorphins release that are chemically calming, she says.

Others, including children ages 11 to 13, cut as a form of experimentation — or because a friend is, says Erin Stoll, an Ellicott City psychologist who specializes in impulse control disorders.

“There’s a lot of discussion at that age about this,” she says. “If they aren’t doing it, a lot of them say they have a friend who is.”

Stoll says she sees someone who cuts on average of at least once a week.

Locations of the cuts also vary. Most kids cut on their arms, legs and stomachs because they are easily reached and easily hidden under clothing, experts say. But any body part is susceptible to the behavior, says Andrew Walen, a psychotherapist specializing in self-harm and founder and executive director of The Body Image Therapy Center in Columbia and Washington, D.C.

After they cut, most kids feel shame and guilt about their behavior, Bomba says. And then, not knowing how to cope with those emotions, the cycle begins again.

While the injuries and act can be jarring for parents, it’s important to know cutting is not a suicide attempt, expert says.

“It’s not a suicidal gesture,” Walen says. “It’s a sign of how distressed they are.”

Click next below to get information about how to help with cutting.

Getting help for cutting

If parents suspect their child is cutting, experts recommend they have a calm, nonjudgmental conversation about it.

“Don’t yell, punish or show anger about it,” Bomba says. “Be open and listen. Help them feel like they are safe and can come to you.”

Walen suggests parents can say something like, “I see you’re in pain, I love you, and I’m going to take care of this for you.”

If their wounds are more than superficial scratches, take them to a medical professional for evaluation. It's also important to find a psychologist, psychiatrist or counselor who can teach appropriate coping skills and determine if there’s an underlying mental illness.

Some teach teens to draw on their arm instead of cutting when they feel numb or the need to mask pain, Stoll says.

“There’s still a mark there, there’s still a message there, but it’s not harmful,” Stoll says.Others use controlled breathing and cognitive behavioral therapy techniques or encourage teens to write in a journal any time they feel intense emotions.

In most cases, consistent therapy works, experts say.

“Most of them don’t want to keep (cutting),” Bomba says. “They know it’s not safe, it’s not helping them in the long run, and they want to change their behavior.”

Recognizing the signs of cutting

Cutting, a form of self-harm, affects boys and girls of all ages. Experts recommend watching for the following warning signs:

Scratches, cuts and scars on the arms, legs and stomach.

Extra accessories and clothing to hide injuries, like bracelets or long sleeves and pants during warmer weather.